What is Little League Elbow

Little league elbow is a condition that develops when the growth plate (apophysis) on the inner side of the elbow bone (medial epicondyle) becomes inflamed from tendons and ligaments pulling on the bone, which causes stress.

Growth plates are areas of cartilage near the ends of long bones where growth occurs. These areas eventually harden into solid bone. Children and teens are more vulnerable to growth plate injuries because their bodies are still growing.

This condition may also be called medial apophysitis or medial epicondylar apophysitis.

What are the causes?

This condition is caused by repetitive overhand throwing.

What increases the risk?

This condition is more likely to develop in young athletes who participate in sports that involve repetitive overhand throwing or a similar motion. These sports include:

• Baseball. This injury is especially common in pitchers.
• Softball.
• Javelin throwing.
• Tennis.

The condition is also more likely to affect young athletes who play the same sport for more than one team, play the sport year-round, or have high pitch counts.

What are the signs or symptoms?

Symptoms of this condition include:

• Pain on the inside of the elbow.
• Swelling.
• Limited range of motion in the elbow.
• Locking of the elbow.

How is this diagnosed?

This condition is diagnosed based on symptoms, a medical history, and physical exam. X-rays may also be done:

• To see if the growth plate is still open and wider than normal.
• To check for other bone problems, such as breaks (fractures) and dislocations.

How is this treated?

Treatment for this condition includes:

• Stopping all throwing activities until pain and other symptoms go away.
• Icing the elbow to ease swelling and pain.
• Doing exercises (physical therapy) as soon as healing is underway.
• Taking an NSAID to reduce pain and swelling.

Follow these instructions at home:

• If directed, apply ice to the injured area:
  • Put ice in a plastic bag.
  • Place a towel between your skin and the bag.
  • Leave the ice on for 20 minutes, 2–3 times a day.
• Gently move your fingers often to avoid stiffness and to lessen swelling.
• Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Do exercises as told by your health care provider.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

How is this prevented?

• Warm up and stretch before being active.
• Cool down and stretch after being active.
• Give your body time to rest between periods of activity.
• Be safe and responsible while being active to avoid falls.
• Maintain physical fitness, including:
  • Strength.
  • Flexibility.
  • Cardiovascular fitness.
  • Endurance.
• Avoid constant participation or over-participation in any one sport. Play other sports that do not involve overhead throwing.
• Young pitchers should:
  • Receive training for proper throwing technique.
  • Rest their throwing arm for at least 24 hours after a game or a practice.
  • Avoid throwing curveballs until age 14 and sliders until age 16.
  • Never play through pain.
  • Avoid overpitching.

Contact a health care provider if:

• Your pain does not get better with 4–6 weeks of rest and treatment.

Get help right away if:

• You are unable to bend or fully straighten your elbow.